Project Summary/Abstract Human immunodeficiency virus (HIV) remains a global threat to human health and an important cause of neurologic and psychiatric disorders, despite advances in longevity due to the use of antiretroviral therapy (ART). ART suppresses HIV replication and allows for partial immune restoration, but may fail to achieve adequate penetration of the central nervous system (CNS). Currently, ART does not eliminate latent HIV, does not clear viral reservoirs, and does not normalize the inflammatory response. Further, some ART may have neurotoxic effects. For these reasons, HIV-associated disorders of the CNS and peripheral nervous system (PNS) have persisted and evolved despite the use of ART in the aging HIV+ population. In order to cure HIV infection of the CNS and to elucidate the pathogenic mechanisms of CNS and PNS disease in ART-treated patients, as well as to continue ongoing studies of aging and HIV co- morbid conditions, NeuroAIDS investigators require a continuous and reliable source of well- characterized human tissues, fluids, and data. These invaluable resources are provided by the National Neurological AIDS Bank (NNAB), a member of the National NeuroAIDS Tissue Consortium (NNTC). Over the past 19 years, the NNAB has enrolled 806 participants, and currently follows a cohort of 171 active participants who have agreed to be tissue donors. Most of our donors have received serial, pre-mortem medical, neurologic, neuropsychologic and laboratory examinations. NNAB has also performed 259 tissue harvests of cohort members. Over the past 5 years, the NNAB has distributed 3,766 frozen tissue specimens, 853 fixed tissue specimens, 23,007 formalin fixed paraffin embedded tissue slides and 3,065 aliquots of fluids to NNTC-approved, qualified investigators. The NNTC is a consortium of 4 geographically dispersed clinical sites and a Data Coordinating Center (DCC). Over the past 5 years, NNTC has collectively fulfilled 123 specimen requests that generated 128 publications. The NNAB actively collaborates with the other NNTC clinical sites and the DCC to develop and maintain standard study protocols, to transfer data to the DCC, to review investigator requests for NNTC resources, and to allocate such resources in a fair and timely fashion. The NNTC works with the DCC to insure we maintain an accurate specimen inventory, and to support the harmonized central NNTC database. The NNAB looks forward to working with our participants, our colleagues, and our requesters for another 5 years to expand and develop this priceless and indispensable scientific resource.